Effect of free amino acids mix with medium triglycerides and Withania somnifera on cancer cachexia.

Abstract

e23140 Background: Cancer cachexia is a multifactorial syndrome involving systemic inflammation, negative protein and energy balance, and involuntary loss of lean muscle mass. It not only adversely affects quality of life but also leads to poor responses to chemotherapy and reduced survival rates. Conventional nutritional support has not been successful in cancer cachexia and most commercially available formulas have shown little to no effect on cancer cachexia. This study assessed nutritional benefits of E2 Energy, an amino acid (AA) supplement powder enriched with branched-chain AAs, medium-chain triglycerides, and Withania somnifera, on body weight, lean muscle mass, and cancer-related piper fatigue score. Methods: This prospective, open-label preliminary feasibility study was conducted in patients receiving active treatment for cancer (e.g. chemotherapy, radiation, targeted therapy, or hormone therapy) with documented evidence of significant weight loss. Patients were evaluated at baseline and at the end of treatment (12 weeks) for lean muscle mass as measured by bioimpedance analysis, body weight, C-reactive protein (CRP), serum albumin, fatigue as measured by Piper Fatigue Scale (PFS), and proinflammatory cytokines (IL-1, IL-2, IL-6, and TNF-α). Being a pilot study, enrollment was restricted to approximately 30 patients with focus on descriptive statistics rather than formal tests of hypotheses. Results: We analyzed data of 15 patients who completed at least 6 weeks of treatment. Treatment with AA powder increased lean muscle mass in 12 (80%) patients. Similarly, PFS scores improved in 14 (93.33%) patients. Overall, in 6 patients (40%), body weight either remained stable or increased from baseline values. Six patients presented abnormal cytokine levels at baseline; however, their results at follow-up were unavailable, thus making interpretation inconclusive. Conclusions: Treatment with AA powder supplement may prevent loss in lean muscle mass, reduce fatigue, and curtail weightloss. However, these results must be substantiated in large well-designed (randomized) studies.